Relationship between 6-n-propylthiouracil (PROP) taster status, dietary intake and dental caries among young adult subjects

@#Introduction: Previous studies have established an association between 6-n-propylthiouracil (PROP) taster and dietary intake. However, those studies mostly emphasised on macronutrients. The present study examined the dietary intake, including macro- and micronutrients, and caries experience among university students according to their PROP taster status. Methods: A total of 158 university students participated in this study. PROP taster status was determined using filter paper method. Dietary intake was collected using 24-hour diet recall method. Oral health examination was conducted to determine dental caries experience. Results: The results showed that majority of subjects were supertasters. No significant differences (p>0.05) were found in the macronutrient intakes among supertasters, medium tasters, and non-tasters. Significant differences (p<0.05) were found in the intakes of micronutrients, namely pantothenic acid, vitamin D, magnesium, manganese, and fluoride. There were no significant differences among group tasters in the dental caries experience scores of decayed (D), missing (M), and filled (F) teeth. Conclusion: In general, this study indicated that all group tasters had no difference in macronutrients intake and caries experience, but supertasters had significantly lower intakes of some micronutrients as compared to non-tasters and medium tasters. This suggested that PROP taster status could have some influence on micronutrient intakes.

Comparison of the sensitivity and specificity of p16/Ki-67 dual staining and HPV DNA testing of abnormal cervical cytology in the detection of histology proven cervical intraepithelial neoplasia grade 2 and above (CIN 2+)

Introduction: Human papillomavirus (HPV) testing is used as a means of triaging cervico-vaginalsmears with low grade squamous abnormalities or as part of co-testing with cytology. While HPVtesting has a high sensitivity, it has a low specificity in detecting cervical intraepithelial neoplasiagrade 2 and above (CIN 2+) leading to unnecessary colposcopy referrals. We investigate the accuracyof the p16/Ki-67 dual immunocytochemical stain in determining the presence of CIN 2+ lesions onhistology and its potential as a superior biomarker for triage. Methods: Liquid based cervico-vaginalcytology specimens with squamous abnormalities and corresponding histology from 97 women withsubsequent colposcopy and biopsy were included. The specimens were then subjected to the dual stainand Roche Cobas 4800 multiplex real time PCR HPV DNA testing. The sensitivity and specificity ofthe dual stain and HPV testing were calculated using CIN 2+ on histology as a reference standard.Results: The sensitivity and specificity of the dual stain in detecting histology proven CIN 2+ was93.7% and 76.5% while HPV testing was 85.7% and 14.7% respectively. Of the 44 women withASCUS or LSIL on cytology, the dual stain also reduced the number of unnecessary colposcopyreferrals from 27 to 7 when used as a triage marker compared to HPV testing. Conclusion: p16/Ki-67dual stain was more sensitive and specific than HPV testing in determining the presence of CIN 2+on histology. It could triage low grade cervico-vaginal specimens more effectively and potentiallyhelp women avoid unnecessary colposcopies. Future studies are needed to further evaluate its rolein cervical cancer screening programmes.

Health-related quality of life of chronic hepatitis c patients attending the outpatient clinics of Assiut University Hospital

Kgypl has possibly the highest chronic hepatitis C [CMC] prevalence in the world, which has been associated with decreased health-related quality of life [HRQoL]. Aim: The aim of the present study was to identify the most important predictors of HRQoL of CMC patients attending the outpatient clinics in Assiut city. HRQoL of 200 CMC patients and 200 age-and sex-matched normal subjects, was assessed by the validated Arabic version of the Medical Outcome Study Short Form Health Survey 36 [SF-36]. All patients were interviewed using a semi-structured questionnaire to assess the factors that could affect their HRQoL. Validated reliable instruments were used lo assess depression, illness-related stigma and disease related worries. HKQoL scores of CMC patients [age 40.43 +/- 12.11, 82.5% males] were significantly lower than age and sex matched controls. The most important predictors of the physical summary score of SF-36 were; depression [beta = 0.611, P = 0.000] and the presence of co-morbidities [beta =- 0.218, P - 0.000].while for the menial summary score, the most important predictors were; depression [beta =- 0,651. P=0.000] and illness-related stigma [beta= 0.222, P = 0.000]. Other factors such as age. Sexual dysfunction, interferon therapy and work affection by CMC illness showed a weaker, but nevertheless statistically significant relationship with HRQoL of CHC patients. The study found that patients with chronic hepatitis C had lower HRQoL than the healthy controls, and, depression, co-morbiditics, illness-related stigma were the most important predictors of their iower HRQoL. The results its of this study would assist healthcare personnel to introduce modifications in patient care protocols with relevance to patient needs

Oxidative stress and c-reactive protein in patients with cerebrovascular accident [ischaemic stroke] the role of ginkgo biloba extract

This study aimed to investigate the presence of oxidative stress and inflammation in ischaemic stroke patients by measuring malondialdehyde [MDA], total antioxidant status [TAS], and highly-sensitivity C-reactive protein [hsCRP] in the early post-ischaemic period, and to determine the role of Ginkgo biloba therapy in correcting the markers of oxidative stress and inflammation. This study was conducted at Ibn Seena Hospital, Mosul City, Iraq and included 31 cerebrovascular accident [CVA] patients and 30 healthy controls. Ischaemic stroke patients were divided into two groups: group I [n = 15] received conventional therapy; group II [n = 16] received conventional therapy with G. biloba [1500 mg/day] for 30 days. Blood samples were obtained from patients and controls before treatment and assays done of serum levels of MDA, TAS, and hsCRP. For CVA patients, a post-treatment blood sample was taken and the same parameters reassessed. Compared with the controls, patients' serum levels of MDA, and hsCRP were significantly higher [P

Oxidant/antioxidant status and immunoglobulin levels in patients with primary brain tumors before and after surgical intervention

To assess serum level of malondialehyde [MDA], total antioxidant status [TAS] as a representative of oxidative stress, with immunoglobulin levels [IgG, IgA, IgM] in patients with primary brain tumors at diagnosis and one month after surgical resection in comparison to healthy controls. The study was conducted in Iben-Seena Hospital in Mosul city Iraq. Thirty-seven patients with primary brain tumors were included in the study, later proved by histopathology to be cases of meningioma [24 cases] and glioma [13 cases]. Also included 32 apparently healthy, age and sex matched subjects as a control group. Initially, blood samples were taken from both the patients and controls and assessment of serum MDA, TAS and immunoglobulin levels [IgG, IgA, IgM] were done, later for the patients group one month after surgical resection of the tumor another blood samples were taken and assessment of the same parameters mentioned above were done again. Serum MDA was found to be significantly higher [p<0.001] and serum TAS was significantly lower [p<0.001] in patients with primary brain tumors [both meningioma and glioma] prior to surgical resection in comparison to controls. Postoperatively, there was a significant reduction [p<0.001] in serum MDA levels with an increase in TAS [which was slightly significant in gliomas and insignificant with meningiomas]. With regard to serum immunoglobulin levels, there was a significant increase in serum IgG [gliomas p<0.05; meningioma p<0.001] preoperatively compared with controls, with a significant reduction [p<0.001] in the serum levels of IgG, IgA and IgM postoperatively in comparison to preoperative values. Primary brain tumors [both meningioma and glioma] as a disease carry a substantial effects on oxidant/antioxidant status and on serum immunoglobulin levels as part of the humoral immunity so as the surgical removal of the tumor mass as a way of therapy

role of glial fibrillary acidic protein [gfap] in the diagnosis of neuroepithelial tumors

The aims of this study are to identify the Immunohistochemical [IHC] expression of Glial Fibrillary Acidic Protein [GFAP] in different types of neuroepithelial tumors in Mosul city and to correlate the results with grade of tumor, with the results of other studies and to assess the diagnostic role of GFAP in the diagnonsis of neuroepithelial tumors and their differentiation from neuroglial tumors. This study included 56 cases of neuroepithelial tumors. 22 cases were collected during the period extending from October 2007 to May 2008. [The rest of the cases were retrieved from a filing system extending back to 2004]. In addition to two miscellaneous tumors, [one meningioma and the other secondary adenocarcinoma]. All cases were obtained from Al- Jamhuri Teaching Hospital in the western side of Mosul City, Northern Iraq and some private laboratories. Typing and grading of the tumors were done according to World Health Organization [WHO] classification system. IHC procedure was done for GFAP using polyclonal antibodies and chromogen visualizing system. A semi-quantitative histochemical score was used to record the results of GFAP staining according to the system established by Catherine L. Nutt et al. Thirty seven cases were diagnosed as astrocytoma, while 8 cases out of ependymoma, 4 cases of oligodendroglioma, and three cases medulloblastoma were shown. In addition, this study revealed that one case for each of: oligoastrocytoma, Medulloepithelioma, atypical rhabdoid tumor and astroblastoma. Glial Fibrillary Acidic Protein [GFAP] was expressed in 85.7% of neuroepithelial tumors. Higher GFAP positivity was found in glioma than other types of neuroepithelial tumors [P value <0.05]. On the other hand, GFAP was expressed in [36%] of astrocytoma. In oligodendroglioma, 3 cases out of 4 were positive while all cases of ependymoma were positive. In addition, oligoastrocytoma was positive while the remaining cases of neuroepithelial tumors were negative. In general, each type of glioma had special staining pattern of GFAP. GFAP status was found to be inversely related with the grade of glioma [P value <0.05]. GFAP is expressed more frequently in glioma than in other neuroepithelial tumors and this result is similar to many other studies done outside Iraq and it is correlated inversely with the grade of tumor. So, it is a valid supplementary diagnostic procedure for neuroepithelial tumors and a reliable marker to differentiate between glial from non-glial tumors on one hand and between different types of glial tumors on the other hand

Levels of adulthood physical disability in a rural community in upper Egypt

Worldwide, the rapid increase in the elderly population have led to an ongoing debate about wheather longer lives can be matched by longer active lives that are free from disability [Ostir, et al., 1999]. In many developing countries, life expectancy is increasing very rapidly, but little information is available on survival free of disability [Jitapunkul et al, 2003]. Egypt is an example of a country in the middle of its demographic transition. The median age of population has risen with a life expectancy at birth from 51 years in 1970 to 70 years in 2005. Egypt's population is projected to reach 92 million in 2020 with 6.7% aged 65 years or above; approximately 7 million elderly people [CAPMAS, 1995]. To estimate the prevalence rate, identify types and factors associated with disability among adults residing in a rural area. A cross-sectional survey with total coverage of all adult population >/= 18 years residing in Gahdam village. Upper Egypt, was undertaken in 2001. A total of 2.505 adults were screened for disability using the ADL [Activities of Daily Living] and IADL [Instrumental activities of daily living instruments. This was followed by a more detailed questionnaire to describe disability by onset, duration, severity, underlying diseases, health seeking behavior and other factors. Disability was defined as deficiency in one or more of ADL or IADL items. 15.9% of adults were disabled in one or more of the ADL items. Using both ADL and IADL instruments the prevalence of disability among adult population aged >/= 18 years was 22.1%. Disability was associated with age, gender, marital status and educational attainment. Musculo skeletal disorders ranked as the first underlying cause of disability [41.9%] followed by chest disorders [16.5%]. Health services utilization declined from 90.9% at the onset of disability to 62.3% among currently disabled adults. Although private sector had the upper hand among providers sought, a large proportion of disabled adults relied on self medication 37.7%. Hospitalization during the last year was 16.4%; with an average length of stay 16.9 days. Disability among elderly population is a significant burden to individuals, families, and health care

Childhood disability levels in a village in upper Egypt

Long term physical disability among children and adolescents is a multi-dimensional problem and though the prevalence rate of disability across age groups is higher among elderly, yet, the severity of disability and psychological impacts among adolescents and young adults is much higher. Children < 18 years of age are more than 50% of the population in developing countries, even low disability levels can amount to substantial suffering. To estimate the prevalence of disability among children <18 years age in a village in Upper Egypt, its impact on the child and family life, and describe the patterns of health care seeking behavior. A cross-sectional survey with total coverage of all children 0-18 years old residing in Gahdam village, Upper Egypt "was undertaken in 2001. A child was considered disabled if he/ she was suffering from a disability in one or more of general activities specific for his/ her age or specific activities general for all age groups. Mothers of 3.448 children were interviewed via a semi-structured questionnaire in the screening phase '10 questions questionnaire' standardized instrument. A sub-sample of the disabled children's mothers was subjected to a more detailed questionnaire on disability. 340 children [9.9%] were perceived by their mothers limited by anyway because their disability or health. General disability was the most frequently reported type followed by speech disabilities. Disability was higher in magnitude and severity in males. Psychological burden among children's families ranked the first [66.7%] followed by economic burden, [31.4%] and lastly 15.7% of disabled children's families were suffering from 'physical effort' burden. The type of disability, course and economic burden were all significant predictors in seeking health care. Development screening is essential for early identification of childhood disability

Health advice seeking behavior during childhood diarrhoea in a semi-urban area in Assiut

To describe the pattern and determinants of health services utilization in case of childhood diarrhea. A cohort of 257 infants, aged 0-9 months was selected from a semi-urban area in Assiut, Egypt, followed up for 12 months from October 1999 to October 2000. Diarrhoeal morbidity data was collected biweekly. Initially a baseline household survey was conducted to collect baseline data on the sociodemographic background of the family and the household environment. When diarrhoea was reported in a child, the mother was asked a standard series of questions on her child's stool frequency, consistency associated symptoms, perception of severity of the attack, her behavior toward her child ot home, the use of health care services, type of provider used and perception of quality of care. Utilization of health services was categorized into outpatient visits; emergency care visits, and hospital admissions. In 53.1% of diarrhoeal episodes mothers sought a health care provider outside the house; mainly from outpatient clinics [87.5%]. Emergency services were used in 7.1% of the episodes and hospital admission occurred in 5.4%. Multivariate analysis revealed that mothers' perception of severity of their children's diarrhoeal episodes held the major determinant for utilization of health services [OR=13.09, P=0.000]. Other determinants of using health services during diarrhoea included factors related to episode characteristics as presence of vomiting [OR=3.1. P=0.000] or fever [OR=2.63, P=0.000] and using of self-prescribing drugs [OR=0.224, P=0.000] for treatment of the episode at home. Mothers also sought medical care for younger infants than older ones [OR=2.42, P=0.001]. No association between utilization of health services and socioeconomic factors was found. Health services utilization in case of childhood diarrhoea interact with multiple factors, but mothers' perception of their children's health status during diarrhoea held the major influence on the utilization of health services. Furthermore, public health services were the most frequent type of services utilized for treatment of diarrhoea

Acetaminophen mimics the action of salbutamol in relaxing gravid human uterus-in-vitro

Management of preterm labour was generally treated by salbutamol even with some expected disturbances is maternal pulmonary oedema, respiratory distress and cardiovascular side effects and neonatal low-size and cellularity of thymus and lymph nodes. This demands finding a substitute free of these side effects. Initially, acetaminophen was tested on rats uterine horns and on pregnant rats and reported an effective relaxation of the uterine horns and profound delay in parturition. These results justified an in-vitro study on strips of gravid human uterus ruptured during difficult labour. Acetaminophen [50 mg] reduced tension by 50% which was comparable to decrease in tension when 5 micro g of salbutamol was added. Profound drop in tension is care of adjunct use of both drugs, while repeated three doses of 50 mg acetoaminophen when added separately resulted in corresponding drops in tension down to below resting level. These findings encouraged future clinical trials on threatened women with abortion since the use of acetaminophen in the usual dosage is effective tocolytic agent without any maternal side effects but with mild possible neonatal lung congestion as a result of transient narrowing of ductus arteriosus especially in advanced gestational age

Pilonidal sinus disease our results with excision and primary closure

Aim: this study was retrospective review of number of patients presenting with pilonidal sinus disease, describing their clinical features and estimating the results of their surgical treatment by simple excision and primary closure

Methods: 19 patients with chronic pilonidal sinus disease were treated between 2000 - 2003 in Sohag Teaching hospital by simple excision and primary suture

Results: the patients included 15 male and 4 female with a mean age of 25.5 y, 14 patients of them [73%] were evidently overweight. All patients had simple excision and primary suture. Only two patients developed recurrence

Conclusion: simple excision and primary closure results in a good healing with an acceptable rate of recurrence

Simple closure of perforted peptic ulcer with addition to helico bacter pylori eradication

The aim of this study was to evaluate the value of adding H. pylori antagonist to simple closure of the perforated ulcer. The study retrospectively analyzed 32 patients with perforated peptic ulcer treated by simple closure and postoperative Helicobacter pylori antagonist. Intraoperative biopsy from the edge of the ulcer revealed +ve infestation to H. pylori in all cases. Two patients had malignant ulcer proved by histopathology and were excluded from this study. The average age was 48.8 years. All patients presented within 24 hours after perforation but four patients were in shock. The morbidity rate was 0%. Three months postoperatively upper GIT endoscopy revealed healing of the ulcer in all cases [100%]. Simple closure and Helicobacter pylori antagonist resolve peptic ulcer perforation with very low morbidity and mortality

Repair of femoral hernias with plug technique

The aim of this study was to evaluate the value of mesh plug in the repair of femoral hernias. It was carried out on 12 patients suffering from femoral hernia and were treated by femoral herniorrhaphy with plug repair. No single case of recurrence or other significant complication was encountered

Molecular genetic profiles of childhood precursor B-acute lymphoblastic leukemia

Currently, many forms of leukemia are considered potentially curable, with prognosis and clinical outcome strongly dependent on the underlying molecular pathophysiology. A substantial number of leukemia patients harbor nonrandom katyotypic abnormalities that define subgroups with unique biological and clinical features. The aim of this work was to-identify precisely some specific genetic changes in childhood precursor B-cell acute lymphoblastic leukemia [Pre B-ALL] by molecular techniques. reverse transdiption-polymerase chain reaction [RT-PCR] was used to detect genetic lesions with their characteristic mRNA splicing variants, occurring in pretreatment de novo 21 children with Pre B-ALL. These included ABL gene product, [9;22] [q34;q11] with BCR/ABL P190 and P210 isoforms and t[1:l9] [q23;p13] with E2A/PBX1. Fluorescence in situ hybridization [FISH] was used to detect t[12;2l] [p13;q22] with TEL/AML1 fusion. 90.5% of childhood pre B-ALL was positive for ABL transcript [including a subgroup with weak positive results representing 14.3% of the total cases] and 9.5% showed negative results. BCR/ABL P190 fusion transcript was detected in 4.8% and BCR/ABL P190/P210 coexpression was detected in 4.8% of cases. t [l;19] was detected in 4.8% of the studied cases, while t[12;21] was detected in 14.3% of the cases. MI children with positive translocation transcripts were below the age of 8 years. RT-PCR and FISH are reliable tools in the clinical screening of leukthnia patients for the presence of specific gene rearrangements with important diagnostic and prognostic implications that may prepare the stage for new classification based on genotyping

role of endoscopic therapy with combined adrenaline injection plus thermo - coagulation in the management of patients with bleeding peptic ulcer

The aim of this study was to evaluate the value of endoscopic treatment with combined adrenaline injection and thermo-coagulation in the treatment of the patients with bleeding peptic ulcer. This study was carried out in Sohag Teaching Hospital over the period extending from November 1999 through December 2002. During this study period, 42 patients were admitted with bleeding peptic ulcer. Of them, 36 patients required endoscopic treatment. The cases included 22 duodenal ulcer and 14 gastric ulcer. Initial hemostasis was successful in 30 patients and rebleeding occurred in 4 patients. The mortality rate was 11.1%

Pregnancy outcome of adolescent marriage within 5 years of marriage

A secondary analysis of a sub-sample of the Egyptian demographic health survey [EDHS-95] data set was undertaken to compare between the pregnancy outcomes of 15-19 year old married adolescent girls and 20-24 years old young adult women who married in their 20th, within 5 years of marriage. Both groups showed differences in their social and demographic background, antenatal, natal and contraceptive use. Married girls and their husbands reside mainly in rural areas and are much lower in their educational level. The antenatal care use was significantly lower among girls than the young adult women, being 45% and 60%, respectively. Home deliveries were very common and different among both groups [51% and 62%, respectively]. Young adult women differed in their timing to use a modern contraceptive for the first time and its use at a higher percentage, in particular after having the first child. The tradition that contraceptives are not used until the birth of one child was found to be strongly prevailing, despite the marked educational differences between both groups. However, despite all the differences mentioned, no differences in the pregnancy outcomes were observed in both groups and even cesarean section rate of the last birth was double in the young adult women compared with married adolescent [12% and 6%, respectively]

Clinical presentation and management of unilateral acute and chronic epidural, hematomas of posterior fossa

Posterior Fossa epidural hematomas [PFEDHs] was detect in 14 patients secondary to the head injury in the period from Jan. 1999 to Feb 2001 - the goal of this study was to analyze the differences in preoperative clinical presentation and management between a group of acute [8 patients] and a group of chronic [6 patients] of epidural hematomas of posterior fossa. In this study [chronic epidural hematomas was defined as a delay of more than 72 hours from the accident to surgery]. All patients were admitted to neurosurgery departments of Al Azhar university hospitals. C.T brain scan without contrast and with bone window was used as a tool for diagnosis, followed by surgical evacuation of the hematoma for all patients. The outcome and good recovery was obtained in 13 patients but only one patient died

Surgical management of superior sagittal sinus in parasagittal meningiomas. Experience with 25 cases and review of literature

Twenty-five patients having parasagittal meningiomas were subjected to surgical intervention and tumor excision. The clinical picture varied according to the location, mass effect and vascular compromise of the tumor along the superior sagittal sinus [SSS]. Magnetic resonance imaging [MRI], MRI venography and computed tomography [CT] were the main tools of investigation. The location of the tumors was 56% in the middle third, 36% in the anterior third and 8% in the posterior third. The SSS was found to be totally occluded in 28%, partially occluded in 24% and patent in 48% of the cases. Postoperatively, the patients were followed up clinically and radiologically with an average follow up period of 22.3 months. The outcome was excellent in 16 patients, good in five patients, poor in two patients and two deaths occurred. The recurrence rate was 8%. It was concluded that the management of the SSS and the cerebral veins draining into it is the primary consideration in the removal of parasagittal meningiomas. The surgical technique depended mainly on the location of the tumor and the degree of SSS involvement. The microsurgical venous anastomosis of the cortical veins and the sinus in the middle and posterior third tumors with partially involved SSS must be considered

Surgical outcome of one level anterior cervical discectomy with and without fusion. comparative study

Sixty patients having one level cervical disc prolapse were surgically treated through anterior approach cervical discectomy with and without fusion. The main symptoms and signs were neck pain [88.3%], radicular pain [96.7%], motor deficits [26.7%] and sensory deficits other than pain [70%]. Twenty-six patients had C5-C6, 19 had C4-C5, 12 had C6-C7 and three had C3-C4 disc herniation. Standard anterior approach cervical discectomy was performed for all cases. Autologous iliac crest bone grafts were used for 26 cases, while the rest of the patients did not receive grafts. The follow up period ranged from six months to three years [average 13 months]. The overall outcome was excellent in 20 patients, good in 32, fair in five and poor in three cases. There was no statistical significant difference between the outcome of both techniques [with and without fusion]

Fronto-orbital advancement and cranial vault remodeling for cases of primary simple bilateral coronal synostosis

A series of 12 children with primary simple bilateral coronal synostosis underwent fronto-orbital advancement and cranial vault remodeling in one stage operation without mortality or notable morbidity was presented in this study. Three patients had a history of previous strip craniectomy in the earlier age. Papilledema was found in six patients and nine patients had radiographic evidences of intracranial hypertension. The average follow up period was 13 months. The outcome was excellent in nine patients and good in three patients without notable morbidity recurrence or mortality